Peeters Karen, Delvaux Peter, Huysentruyt Frederik
a Department of General and Abdominal Surgery , AZ Klina Brasschaat , Brasschaat , Belgium.
Acta Chir Belg. 2017 Aug;117(4):260-263. doi: 10.1080/00015458.2016.1258785. Epub 2016 Nov 23.
Intraductal papillary neoplasm of the bile duct (IPNB) is a rare variant of bile duct tumors, characterized by papillary growth within the bile duct lumen and is regarded as a biliary counterpart of intraductal papillary mucinous neoplasm (IPMN) of the pancreas. IPNBs are mainly found in patients from Far Eastern areas, where hepatolithiasis and clonorchiasis are endemic. The Western experience, however, remains limited. In this article, we report a 56-year-old man, referred to our hospital because of deranged liver function tests. Further imaging modalities showed a cystic lesion of 9 cm diameter, arising from the left hepatic duct. Inlying was a heterogeneous, lobulated mass. The patient underwent a left hemihepatectomy and adjuvant chemotherapy. Despite recent advanced technologies, diagnosis of IPNB is still challenging, especially in western countries due to its rarity. Early identification and resection of lesions, even in asymptomatic or minimally symptomatic patients, are however important prognostic factors.
胆管内乳头状肿瘤（IPNB）是胆管肿瘤的一种罕见变异类型，其特征为在胆管腔内呈乳头状生长，被视为胰腺导管内乳头状黏液性肿瘤（IPMN）的胆管对应物。IPNB主要见于远东地区的患者，这些地区肝内胆管结石和华支睾吸虫病呈地方性流行。然而，西方的经验仍然有限。在本文中，我们报告了一名56岁男性，因肝功能检查异常转诊至我院。进一步的影像学检查显示，一个直径9厘米的囊性病变起源于左肝管。病变内部为一个不均匀的分叶状肿块。该患者接受了左半肝切除术及辅助化疗。尽管有了近期的先进技术，但IPNB的诊断仍然具有挑战性，尤其是在西方国家，因为其较为罕见。然而，即使是无症状或症状轻微的患者，早期识别并切除病变也是重要的预后因素。
